How Are Damages Calculated in a California Personal Injury Case if I Have a Preexisting Condition?
Injured in an accident but also dealing with a preexisting condition? You may have a lot of personal injury FAQs and be trying to tabulate the impact your preexisting condition will have on your personal injury claim. Specifically, how can you demonstrate that the injuries you’re dealing with now are a result of the crash or accident and not just a flare-up of your condition? It’s a common concern, and the answer often lies in the causation and how damages are calculated.
When you have a preexisting condition and you’re involved in an accident, things get more complicated than in a typical personal injury case. The defense can and will likely attempt to argue that the injuries and symptoms experienced weren’t the result of the incident at all. Instead, they might try to claim that your preexisting condition is, in fact, to blame for any pain and treatment you are seeking compensation for. While this can complicate your claims process, it doesn’t mean you can’t receive compensation for your injuries.
The Role of Causation in Personal Injury Cases with Preexisting Conditions
Causation is one of the main factors in any personal injury case––but what does “causation” even mean? As straightforward as possible, it’s the act of proving the reason or cause behind an outcome or result. So, in terms of a claim, it’s proving that a defendant’s actions directly caused the injuries you’re claiming. When it comes to preexisting conditions, the defense will likely argue that your current symptoms are the result of your medical history, not the accident. If you have a history of back pain or spasms, they may argue that your new pain is just an extension of your preexisting condition, not an outcome of the accident.
However, California law permits compensation for the aggravation of preexisting conditions. If your accident exacerbated your condition or ignited symptoms you didn’t already have prior to the new injury, you might be entitled to damages. The challenge, of course, is confirming that the accident made things worse and wasn’t just a minor incident that wouldn’t have caused the same symptoms otherwise.
Independent Medical Evaluations (IME) and the Importance of a Thorough Assessment
Getting through the issue will likely come down to the need for an independent medical evaluation (IME). The type of eval required includes a third-party physician, usually assigned by the court or your lawyer, who will assess your medical condition. California actually outlines guidelines for IMEs in the CA Code of Civil Procedure §2032.220. The purpose of an IME is to objectively determine what portion of your current symptoms and treatment needs are being caused by the accident versus what may be attributed to a preexisting condition.
The IME doctor reviews all the medical records provided, looks carefully at prior injuries or conditions you may have struggled with, and examines your current bill of health. They’ll then determine what portion of your current condition can be associated with the accident. For instance, if you’ve had neck pain for a decade from an earlier injury or a degenerative disorder, but the accident caused you to enter a new level of pain or mobility issues, the IME doctor might determine that a certain percentage of your current pain is directly linked to the accident.
The IME doctor will look closely at:
- Your Medical Charts: The doctor will examine your full medical history, including any preexisting conditions, prior medical treatments, and how those conditions have impacted your overall health.
- The Accident: Specific details of the accident, like level and type of impact, how it happened, and the symptoms you experienced immediately afterward.
- Current Symptoms: An evaluation of your current injuries, including the pain and limitations you may be experiencing as a result of the accident.
- Medical Records: These are reviewed to compare your current condition with your health status before the accident.
The goals of the IME are not just to provide an opinion on whether the accident aggravated your condition and elements but also to assign the appropriate portion of responsibility for damages. Thus, if the accident made your preexisting condition worsen, the IME physician will determine how much of the injury can be attributed to the accident versus how much may have happened due to your condition.
How Much Does Your Preexisting Condition Weigh on Compensation?
Once causation is indicated and established, the next steps involve calculating the damages. In personal injury cases, damages can be compartmentalized into different categories: economic damages and non-economic damages.
If you are someone with preexisting conditions, the calculation of your damages is going to include any additional suffering or losses introduced by the accident, but it may not cover the full extent of your preexisting condition. IME become critical in these instances as it helps to determine how much of your current medical treatment and pain is attributed to the accident versus your condition.
Let’s check out the breakdown of compensation:
- Economic Damages: Items in this category include past and future medical expenses, lost wages or earning potential, and any other out-of-pocket costs you incurred due to the accident. If your preexisting condition made you more vulnerable to injury, you may still receive compensation for the additional medical treatment required because of the aggravation caused by the incident.
- Non-Economic Damages: Elements in the non-economic category are much more subjective, covering pain, suffering, emotional distress, and loss of enjoyment of life. If your preexisting condition was aggravated by the accident, you could still be eligible for compensation for the new pain and suffering caused by the worsening of your condition. Note that if the pain you’re experiencing is just a continuation of what you had before the accident, it may not be fully compensable.
For Example, if you had a minor back issue pre-accident, but the collisions led to more severe, long-term pain or additional medical complications, your compensation would reflect the new accident-related issues rather than just the preexisting ones.
How Do You Strengthen Your Case?
To maximize your compensation and beef up your case, it’s crucial to:
- Be Transparent: Always give your attorney your entire medical history. Be upfront about any previous injuries or conditions. While it may seem like a disadvantage to disclose your past, withholding information can actually really harm your case and even hinder your lawyer’s ability to position you best for as much compensation as possible.
- Follow The Treatment Plans: Make sure to follow all prescribed treatments and therapies to a T. If you’re prescribed physical therapy or other treatments––do them! If you fail to follow through with your therapy, the defense can claim your condition worsened because of your own inaction, not the accident.
- Work with Your Attorney: Having a skilled lawyer who knows how preexisting conditions affect personal injury claims is pivotal. They know how to identify the right medical expert to evaluate your condition, are familiar with the entire legal aspect, and can ensure your case is as strong as possible and presented as accurately as possible.
- Consult with a Medical Expert: In addition to the IME, get the treating physician to provide testimony about the accident’s impact on your preexisting condition and health to strengthen your case.
Injuries are complex, especially when you won’t be able to receive compensation for injuries sustained in an accident. If you seek personal injury compensation while having a preexisting condition, do not assume the defense will win on causation alone. With the right approach, you can ensure that the damages you receive reflect the full extent of your suffering and losses. Contact an experienced and trusted California personal injury attorney, Moga Law Firm, located at 1010 N Euclid Ave, Upland, CA 91786 for a complimentary consultation. You may also reach us at 909-931-2444.
Scot Thomas Moga, a dedicated attorney in San Bernardino & Riverside Counties who represents clients in the many types of personal injury, workers’ compensation and estate planning cases.
